Congruence of Patient Self-Rating of Health with Family Physician Ratings.

Background: A single self-rated health (SRH) question is associated with health outcomes, but agreement between SRH and physician-rated patient health (PRPH) has been poorly studied. We studied patient and physician reasoning for health ratings and the role played by patient lifestyle and objective health measures in the congruence between SRH and PRPH.

Methods: Surveys of established family medicine patients and their physicians, and medical record review at 4 offices.

Search Activity in Anorexia Nervosa and Bulimia Nervosa in the Acute Stage of the Illness and Following Symptomatic Stabilization.

Background: We examined problem-solving strategies in anorexia nervosa-restricting (AN-R) type and in normal weight binge/purge (B/P) eating disorders (EDs).

Method: Twenty-four inpatients with AN-R and 22 with B/P EDs were assessed within two weeks of admission and two weeks from discharge for problem-solving, ineffectiveness, ED symptomatology, depression and anxiety; 32 controls were similarly assessed once.

Results: While we found less adaptive problem-solving strategies in patients with B/P EDs vs.

Lucid dreams: their advantage and disadvantage in the frame of search activity concept.

Search activity (SA) is the behavioral and mental activity that is oriented to changes of the environment or of the subject's view and approach to the environment according to personal needs without the definite probability forecast of the outcomes of such activity, but with a regular consideration of the outcomes in the process of active behavior. Dream's lucidity (the subject's realization that he/she is dreaming) protects dreamer from awakenings during emotionally disturbing or frustrating dreams, because lucid dreams allow subject to feel separated from the dream events that may cause a feeling of helplessness. Due to such a protection from awakenings that can bring subject back to the frustration in wakefulness, subject can turn in the further sleep to normal non-lucid dreams that are restoring subject's SA in the subsequent wakefulness (activity in the uncertain situation with the feedback between behavior and its outcome).

Functional brain asymmetry as a determinative factor in the treatment of depression: theoretical implications.

Depression is characterized by the functional insufficiency of both left and right hemispheres. Patients who respond to antidepressants are characterized by a relatively higher left hemisphere activity in comparison to non-responders, and successful treatment with antidepressants increases left hemisphere activity. Left hemisphere is responsible for the goal-oriented behavior that includes search activity as a state opposite to depression, which accounts for the positive outcome in depression following activation of the left hemisphere.

The peculiarity of the right-hemisphere function in depression: solving the paradoxes.

Depression is characterized by functional insufficiency of the right hemisphere combined with its physiological overactivation. This paradox can be solved in the frame of the general concept of brain laterality. According to the present assumption, the left hemisphere organizes any information in an unambiguous monosemantic context, and this process requires an additional activation of the brain cortex in order to restrict natural relationships between objects and events.

Dream content of schizophrenic, nonschizophrenic mentally ill, and community control adolescents.

This study compared the manifest dream content of 20 schizophrenic adolescent inpatients whose medications were stable for at least four weeks, 21 adolescent inpatients with other mental disorders (nonschizophrenic group) matched for age and gender, and 31 matched community controls. All participants were administered the standardized Formal Dream Content Rating Scale (FDCRS), which evaluates dream-related anxiety, cognitive disturbance, implausibility, involvement, primitivity, and recall, as well as two additional scales measuring emotional expression and duration of dream report. The Positive and Negative Symptoms Scale (PANSS) was administered to the two inpatient groups.

Sleep after immobilization stress and sleep deprivation: common features and theoretical integration.

The goal of the present paper is to elucidate and to resolve contradictions in the relationships among different forms of stress, sleep deprivation, and paradoxical sleep (PS) functions. Acute immobilization stress and the stress of learned helplessness are accompanied by an increase of PS, whereas the stress of defense behavior and the stress of self-stimulation cause PS reduction. Recovery sleep after total sleep deprivation performed on the rotating platform is marked by a dramatic rebound of PS although NREM (non-rapid eye movement) sleep deprivation is more prominent than PS deprivation.

Sleep deprivation in depression: An integrative approach.

The question as to whether the beneficial effect of sleep deprivation in depression is related to the increased wakefulness or to the sleep suppression by itself, is made moot by the search activity concept. According to this concept, rapid eye movement (REM) sleep is functionally deficient in depression and increases feelings of helplessness and hopelessness instead of restoring mood and search activity. Thus, REM sleep deprivation, either selective or not, is beneficial by breaking a vicious circle: depression in wakefulness…giving up (helplessness) in dream scenario…increased depression in the subsequent wakefulness.

REM sleep latency and wakefulness in the first sleep cycle as markers of major depression: a controlled study vs. schizophrenia and normal controls.

Introduction: REM sleep latency is a clinically significant sleep variable that is found to be decreased in several psychiatric disorders. However, it is not known whether alteration of REM sleep latency is similar across disorders. In order to test whether incorporation of wakefulness in the first sleep cycle has a different outcome on REM sleep latency in different clinical groups, the authors have investigated correlation between sleep variables in the first sleep cycle in 25 patients with major depression, 24 patients with chronic schizophrenia, and in 10 healthy subjects.

First-night effect of melatonin treatment in patients with chronic schizophrenia.

The first-night effect (FNE) is the tendency for individuals to sleep worse than normal during their first night of polysomnographic sleep evaluation. FNE reflects the adaptive increase of alertness and perhaps the stress resulting from an unfamiliar sleeping environment. This effect is usually absent in patients with chronic schizophrenia.

Melatonin improves sleep quality of patients with chronic schizophrenia.

Background: Accumulating evidence indicates decreased melatonin levels in patients with schizophrenia. Insomnia, mainly difficulty in falling asleep at night, is commonly reported in this population. Association of insomnia with low or abnormal melatonin rhythms has been repeatedly documented.

Interrelationships between nocturnal sleep, daytime alertness, and sleepiness: two types of alertness proposed.

The authors studied daytime sleepiness and alertness (based on the Multiple Sleep Latency Test [MSLT] and Maintenance of Wakefulness Test [MWT]) and nocturnal sleep in 22 patients with depression/anxiety and in 47 nondepressed patients with sleep apnea. The patients underwent two overnight sleep studies followed by daytime tests. In depressed patients, MWT scores correlated negatively with total sleep time and stage 3.

Human memory, cerebral hemispheres, and the limbic system: a new approach.

An integrative approach to human memory is presented in the context of brain asymmetry. The results of psychophysiological investigations suggest that right-hemisphere functioning is closely associated with the limbic system; that association leads to the formation of a polysemantic context. Polysemantic context is determined by multiple interconnections among its elements; each element bears the stamp of the whole context.

Change of mood during sleep and REM sleep variables.

Polysomnography was performed during two consecutive nights in 23 patients with major depression. After every final awakening patients estimated the change of their mood from evening to morning: 1. Mood worse in the morning than in the evening; 2.

First night effect in depression: new data and a new approach.

Polysomnography was performed in 20 depressed patients and 8 normal controls for 2 consecutive nights. A subset of patients had 3 consecutive nights. Patients were assigned to groups according to the presence (group I) or absence (group II) of a first night effect (REM sleep latency on the first night in the laboratory was at least 30 min longer than on the second night).

REM sleep in depressed patients: different attempts to achieve adaptation.

Twenty-seven depressed patients and 10 healthy subjects were investigated in the sleep laboratory during two to three consecutive nights. Eleven of the 27 patients demonstrated the "first night effect" (group I) and 11 other patients demonstrated a clear absence of the "first night effect" (group II). Five of the 27 depressed patients were omitted from the study because they did not fit criteria for first night effect.

To inform or not to inform--a decision with psychobiological implication.

A patient, being informed about his dangerous or even fatal disease, like cancer, has a higher chance to give up and display a renunciation of search activity. Such renunciation decreases body resistance and makes the overall situation hopeless. Thus a person has the right to be not informed about such diseases, because he has the right to use all his inner resources for survival.

Psychoneuroimmunology: searching for the main deteriorating psychobehavioral factor.

Psychoneuroimmunology has become an independent science with a broad experimental basis. However, its theoretical basis is still very vague and ambiguous. There are many contradictions in the experimental data that have not been integrated into a united conception, and some accepted paradigms that remain doubtful.

Psychosocial problems faced during absorption of Russian-speaking new immigrants into Israel: a systematic approach.

The problems faced by immigrants during the absorption process are multidimensional and require a systematic approach. According to the authors' theoretical perspective and clinical experience, two main principles determine the "facets" of absorption: search activity and self-esteem. The paper begins with a definition of search activity and its relationship to self-esteem and then discusses intrapsychic and environmental blocks to search activity and their effect on self-esteem.

The revised monoamine hypothesis: mechanism of antidepressant treatment in the context of behavior.

The temporal restoration of brain monoamines in the synaptic cleft due to MAO inhibition or by blocking catecholamine reuptake is only the first step on the way to recovery from depression. The second and crucial step represents the feedback system, which can provide the continuous restoration of brain monoamines in the context of free search behavior. This feedback system on the one hand helps to overcome depression and on the other hand causes the hyposensitivity of the postsynaptic catecholamine (CA) receptors, due to the increased activity of the brain CA system.

An integrative psychophysiological approach to brain hemisphere functions in schizophrenia.

The present paper proposes a new psychophysiological approach to the genesis of positive and negative schizophrenic symptoms. According to this approach, the initial factor in schizophrenic disorders is a functional insufficiency of the right hemisphere which can be determined by early emotional experience in combination with subtle brain damage. This functional insufficiency causes (a) the inability to grasp and select information before its realization; and (b) the inability to produce a polysemantic context which is crucial for creativity, psychological defense, and the restoration of search activity, all of which determine psychophysiological adaptation to the environment.